Khalifa AA, Abdelaal AM, Moustafa MM. Does surgeon handedness affect the outcomes after primary total knee arthroplasty? A retrospective cohort study. World J Orthop 2026; 17(2): 113696 [PMID: 41695728 DOI: 10.5312/wjo.v17.i2.113696]
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06206735
Submitted on:
February 13, 2026, 18:11
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Reader Comments:
I read with great interest the study by Khalifa et al. published in the World Journal of Orthopedics, evaluating the impact of surgeon handedness on radiological and functional outcomes following primary total knee arthroplasty (TKA). The authors should be commended for addressing an underexplored yet clinically relevant surgeon-related variable in arthroplasty practice.
The finding that overall limb alignment and functional outcomes were not significantly influenced by operating on the dominant versus non-dominant side is reassuring. However, the increased incidence of tibial component malalignment (MPTA outliers) on the non-dominant side highlights an important technical nuance that may have implications for implant longevity, particularly in mechanically aligned TKA performed with conventional instrumentation.
The subgroup analysis comparing intramedullary and extramedullary tibial guides is particularly interesting, suggesting that technique selection may interact with laterality. These findings underscore the potential value of ergonomic optimization and heightened intraoperative vigilance when operating on the non-dominant side.
Future prospective studies incorporating sagittal and rotational alignment parameters, inclusion of left-handed surgeons, and long-term survivorship data would further clarify the clinical significance of these observations. Additionally, evaluating whether navigation or robotic assistance mitigates the subtle asymmetries associated with surgeon handedness could provide valuable insights.
Overall, this study contributes meaningfully to the ongoing discussion regarding modifiable surgeon-related factors influencing TKA precision and outcomes.